
                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: TUESDAY, March 30, 1993                   TAG: 9303300243
SECTION: EXTRA                    PAGE: 6   EDITION: METRO 
SOURCE: LYLE BREITKOPF ASSOCIATED PRESS
DATELINE:                                 LENGTH: Medium

GREATER SUCCESS BEING ACHIEVED IN TREATMENT OF ENDOMETRIOSIS

Although endometriosis is a frustrating illness that can often go undetected for years, education and awareness are leading to greater success in treatment of the disease.

Endometriosis, believed to affect more than 10 million American women, is the result of menstrual tissue which implants itself outside of the uterus, forming adhesions or cysts in the abdominal cavity.

If uncorrected, even minor adhesions and scarring can result in fertility problems.

The symptoms of endometriosis, most prevalent in women 25 to 40, can range from minor backache to severe infertility. Warning signs of endometriosis include painful, heavy and skipped periods, pain during intercourse, irregular cycles, and cyclic rectal bleeding.

Treatment depends on a variety of factors, including the age and health of the patient, the severity of the condition and the desire of the woman to have children.

The earlier the disease is discovered, the better the chance to avoid fertility problems. And the only sure diagnosis is through a visual inspection or biopsy with an instrument called a laparoscope.

With the ability to actually see the extent of the adhesions or cysts, physicians can make a more effective choice from the many treatments.

These options range from medication to laser surgery with a broad combination in between. Some cases are so mild they do not require any special treatment.

Drugs to temporarily prevent menstruation, including oral contraceptives or progesterone, may be given to help reduce the lesions.

There also are nasal sprays containing a drug which works directly on the pituitary gland, leading to a rapid reduction of estrogen levels.

Medications such as ibuprofen may be recommended to reduce pain and inflammation, with only limited effect on the menstrual cycle.

A promising new treatment may come with government approval of the controversial oral contraceptive, RU-486. Studies in France and on the West Coast indicate the drug often relieves pain of endometriosis for patients who do not respond to other drugs.

Even when medication does provide successful pain relief, more severe cases of endometriosis may require surgery to remove the adhesions.

Dr. Lyle Breitkopf is a clinical professor of obstetrics and gynecology at New York University Medical Center.

by CNB